Garden Banks Gas Pipeline, LLC

Original Volume No. 1

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Effective Date: 05/10/2010, Docket: RP10-594-000, Status: Effective

Third Revised Sheet No. 296A Third Revised Sheet No. 296A

Superseding: Second Revised Sheet No. 296A

 

EXHIBIT "B"

INTERACTIVE INTERNET WEBSITE ACCESS REQUEST FORM

 

Authorized Employee/Agent's Name: ________________________________________

 

Email Address _________@_________

 

Company (Employer):________________ Phone No.: _________

 

Facsimile No.: _________

Mailing

Address:______________________City:________________State:_________Zip:_______

Physical

Address:_____________________City:________________State:_________Zip:_______

 

SHIPPER COMPANY INFORMATION:

Complete Legal Name:_______________________________________________________

Mailing

Address:____________________City:________________State:_____Zip:_______

Physical

Address:___________________City:________________State:_____Zip:_______

 

DUNS No.:______________________ Federal Tax ID No.: ___________________

 

Indicate Update Capabilities for this Authorized Employee/Agent:

_____ Execute Contracts, Amendments and Accept Discounts

_____ Make Imbalance Elections/Trades

_____ Request New Service, Amendments and Discounts

_____ Receive and administer the payment of any and all invoices

_____ Submit Capacity Release Offers, Bids, Recall and Reput

_____ Submit Confirmations, PDAs, Storage Transfers

_____ Submit Nominations and Storage Transfers

_____ View only access to Interactive Internet Website screens, email,

web page and reports for SHIPPER will be available to SHIPPER'S

authorized employee

USER'S Signature:_________________________ Date: ____________________________

Officer of SHIPPER Company Signature: ____________________ Title:____________

Officer of SHIPPER Company Printed Name: ____________________ Date:__________

 

FOR INTERNAL USE ONLY

Garden Banks Gas Pipeline, LLC Officer Signature:_____________________

Date:__________

Title: ________________________________

Printed Name:_________________________

 

 

USER ID: ______________________________ Shipper# (if no DUNS) _______________

 

Security approved by:___________________ Date: _____________________________

PLEASE FAX COMPLETED FORM TO (832) 214-5791